脑脊液细胞因子检测在小儿中枢神经系统感染鉴别诊断中的意义  

Differential diagnostic significance of cytokines in cerebrospinal fluid of children with acute central nervous system infections

作　　者：金玉[1] 薛君莉[1] 余唯琪[1] 林丽星[1] 

机构地区：[1]兰州医学院第一附属医院儿科,730000

出　　处：《中华儿科杂志》2002年第4期199-201,共3页Chinese Journal of Pediatrics

基　　金：甘肃省自然科学基金 (ZR 96 0 80 )

摘　　要：目的　探讨脑脊液 (CSF)γ 干扰素 (IFN γ)、粒细胞集落刺激因子 (G CSF)、α肿瘤坏死因子 (TNF α)、白细胞介素 6 (IL 6 )及白细胞介素 8(IL 8)的变化在小儿中枢神经系统感染 (CNSI)中的诊断价值。方法　采用双抗体夹心ELISA法检测 14例化脓性脑膜炎 (PM)、30例病毒性脑膜炎 (VM)及2 2例非中枢神经系统感染患儿CSF中IFN γ、G CSF、TNF α、IL 6及IL 8水平。结果　PM组G CSF及IL 8[(132± 4 1)、(2 5 3± 0 5 6 ) μg/L]水平明显高于VM组 [(5 3± 2 2 )、(0 5 3± 0 4 6 ) μg/L](P <0 0 0 1) ;IFN γ在VM组 [(2 0± 0 4 ) μg/L]水平明显高于PM组 [(0 8± 0 5 ) μg/L](P <0 0 1) ;各脑膜炎组中TNF α及IL 6水平均高于对照组 (P <0 0 0 1) ,但各组间比较差异无显著性。G CSF及IL 8水平增高程度与CSF中性粒细胞计数呈正相关 ;IFN γ增高程度与CSF白细胞数及葡萄糖定量间无相关性。结论G CSF、INF γ及IL 8在CSF中显著增高有助于PM与非PM的鉴别诊断 ;TNF α、IL 6在感染性脑膜炎发病过程中的作用是非特异性的 。Objective To investigate the diagnostic value of cytokines in central nervous system infection (CNSI), the levels of interferon gamma (IFN γ), granulocyte colony stimulating factor (G CSF), tumor necrosis factor α(TNF α), interleukin 6 (IL 6) and interleukin 8 (IL 8) in the cerebrospinal fluid (CSF) were measured in the children with CNSI of different etiology Methods The concentrations of IFN γ, G CSF, TNF α, IL 6 and IL 8 were measured in the CSF of 66 children, of whom 14 patients had purulent meningitis (PM), 30 patients had acute viral meningitis (VM), and 22 were control children without CNSI The ages were from 5 months to 13 years The concentrations of cytokines were detected by enzyme linked immunosorbent assay (ELISA) The CSF specimens were analyzed for the white blood cell count, glucose and the concentrations of IFN γ, G CSF, TNF α, IL 6 and IL 8 Results The CSF levels of G CSF and IL 8 were significantly higher in the PM group [(132±41), (2 53±0 56) μg/L] than in the VM group [ (53±22), (0 53±0 46) μg/L] and control group [(41±24), (0 38±0 29) μg/L, P <0 001] The IFN γ concentration was markedly higher in the CSF of patients with VM [(2 0±0 4) μg/L] than patients with PM [(0 8±0 5) μg/L, P <0 01] and control group [(0 6±0 5) μg/L, P <0 001] The TNF α and IL 6 concentrations were obviously higher in the PM group [(3 21±1 36) μg/L] and VM group [(2 23±1 05) μg/L] compared with the control group [(0 45±0 23) μg/L, P < 0 001] No significant difference was found between PM group and VM group in TNF α and IL 6 levels in CSF The concentrations of G CSF and IL 8 in the CSF were positively correlated to the neutrophil count ( r =0 182, P =0 022; r =0 201, P =0 032) The IFN γ, TNF α and IL 6 concentrations were not correlated to the neutrophil count, glucose and protein amounts in CSF( r =0 087, r =0 075, r =0 122, P >0 10) Conclusion The cytokines i

关 键 词：中枢神经系统感染 细胞活素类 脑脊髓液 鉴别诊断 儿童 

分 类 号：R741.04[医药卫生—神经病学与精神病学]